Provider Demographics
NPI:1558596080
Name:WESTON, MONICA (AUD, CCC-A/SLP)
Entity Type:Individual
Prefix:MS
First Name:MONICA
Middle Name:
Last Name:WESTON
Suffix:
Gender:F
Credentials:AUD, CCC-A/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1182 SW 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:OR
Mailing Address - Zip Code:97914-2130
Mailing Address - Country:US
Mailing Address - Phone:801-580-5547
Mailing Address - Fax:
Practice Address - Street 1:1182 SW 4TH AVE
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:OR
Practice Address - Zip Code:97914-2130
Practice Address - Country:US
Practice Address - Phone:541-881-0970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-28
Last Update Date:2018-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDAUD-2992231H00000X
UT7360663-4102235Z00000X
OR30851231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist